原发性肾病综合征患者血清肿瘤坏死因子-α的水平及其临床意义  

Level and clinical significance of serum tumor necrosis factor alpha in patients with primary nephrotic syndrome

作　　者：项新[1] 冯振伟[1] 何坤[1] 陆玲娜[1] 施燕春 XIANG Xin;FENG Zhen-wei;HE Kun;LU Ling-na;SHI Yan-chun(Department of Nephrology,Rheumatology and Immunology Minzu Hospital Affiliated to Guangxi Medical University,Nanning 530001,China)

机构地区：[1]广西医科大学附属民族医院肾内风湿免疫科,南宁市530001

出　　处：《广西医学》2018年第7期767-770,共4页Guangxi Medical Journal

基　　金：广西医科大学青年科学基金(GXMUYSF201338)

摘　　要：目的探讨原发性肾病综合征(PNS)患者血清肿瘤坏死因子-α(TNF-α)的水平及其临床意义。方法选择PNS患者75例(PNS组)及健康体检者40例(对照组)作为研究对象,检测两组患者治疗前、治疗后8周的血清TNF-α水平,分析PNS组患者治疗前血清TNF-α水平与各项临床指标的相关性,比较治疗前后各类型及不同治疗效果PNS患者血清TNF-α水平。结果 PNS组血清TNF-α水平高于对照组(P<0.05)。治疗前血清TNF-α水平与C-反应蛋白(CRP)、24 h尿蛋白呈正相关(P<0.05)。5种病理类型PNS患者治疗前血清TNF-α水平比较差异有统计学意义(P<0.05),其中以微小病变型肾病患者血清TNF-α水平最高,激素治疗8周后5种病理类型PNS患者血清TNF-α水平均下降(P<0.05)。治疗有效组治疗8周后血清TNF-α水平较治疗前下降(P<0.05),治疗无效组治疗前后血清TNF-α水平比较,差异无统计学意义(P>0.05)。结论血清TNF-α可能参与PNS的发病过程,动态检测血清TNF-α对PNS患者病理分型及疗效判断具有重要价值。Objective To analyze the level of serum tumor necrosis factor alpha(TNF-α)in patients with primary nephrotic syndrome(PNS),and to explore its clinical significance.Methods Seventy-five patients with PNS(PNS group)and 40 individuals receiving healthy examination(control group)were enrolled,and the levels of serum TNF-αwere detected in the two groups before and after 8 weeks of treatment.The correlation of serum TNF-αlevel with each clinical indicator was analyzed in the PNS group before treatment;the levels of serum TNF-αwere compared among PNS patients of different types or with different therapeutic effects.Results The level of serum TNF-αin the PNS group was higher than that in the control group(P<0.05).The level of serum TNF-αbefore treatment positively correlated with C-reactive protein(CRP)and 24 h urine protein(P<0.05).There was a statistically significant difference in the level of serum TNF-αamong PNS patients of five pathological types before treatment(P<0.05),and the highest level of serum TNF-αwas observed in the patients with minimal change nephropathy,and the levels of serum TNF-αdecreased in the patients of five pathological types after 8 weeks of hormonotherapy(P<0.05).After 8 weeks of treatment,the level of serum TNF-αin the effective treatment group decreased compared to the level before treatment(P<0.05),while the level of serum TNF-αbefore treatment did not statistically differ from the level after treatment in the ineffective treatment group(P>0.05).Conclusion Serum TNF-αmay involve in the pathogenesis of PNS,and dynamic detection of serum TNF-αis of great value in the pathological classification and prognostic assessment of patients with PNS.

关 键 词：肾病综合征 肿瘤坏死因子Α 病理分型 

分 类 号：R692[医药卫生—泌尿科学]